Medizin aus dem Computer

Small molecules can have a significant effect on human metabolic processes. Computational drug design aims at constructing specialized small molecules that selectively and efficiently address specific proteins. The basic ideas of computational molecular design are presented and it will be shown how a virtual protein can be computer designed. This virtual protein can be used to predict the binding affinity of given small molecules without having to synthesize them in a laboratory. Modern computational drug design goes far beyond the lock and key principle. Possible future developments are discussed and a current successful example of computational drug design in the field of painkiller medication is demonstrated.     

Die Evidenz (in) der Evidence-Based Medicine

Zusammenfassung Die "Evidenz Based Medicine" (beweisgestütztes ärztliches Handeln) ist ein neuer Versuch, das Problem des Transfers wissenschaftlicher Erkenntnisse in die ärztliche Praxis zu lösen. Die Annahme, dass nur das bewiesen sei, was durch randomisierte kontrollierte Studien belegt ist, trifft zwar für viele, aber bei weitem nicht für alle Fragestellungen zu. Wie an einem historischen und zahlreichen neueren Beispielen erläutert wird, gibt es noch eine andere, ebenso stringente Beweisführung, die - unausgesprochen - auf einem historischen Vergleich beruht. Diese Form des Beweises wäre noch genau zu definieren, um sie vor der Inanspruchnahme durch die alternative sog. Erfahrungsmedizin zu schützen. Die Behauptung, nur 20% aller schulmedizinischen Verfahren seien wissenschaftlich bewiesen, ist aus mehrfachen Gründen verfehlt, weil nicht zu belegen. Die Wahrheitsfindung durch Metaanalysen wird erheblich relativiert. Die heutigen Informations- und Dokumentationstechniken werden manche Schritte im Transferprozess erleichtern. Entscheidend wird sein, ob der letzte Schritt, die Rationalität ärztlichen Handelns und damit die Patientenversorgung zu verbessern, gelingt. Diese Evidenz ist noch zu erbringen. Abstract Evidence-based medicine is a new approach to improve the transfer process of knowledge from research to medical practice. The assumption that only results of randomized controlled studies are evident is true for many but by far not for all clinical problems. As is demonstrated from one historical and many recent examples, there exists another but equally stringent method of proof which is based on an implicit historical comparion. This kind of evidence still has to be defined exactly in order to protect it from misuse by alternative medicine. The statement that only 20% of methods used in conventional medicine are not evidence-based cannot be substantiated. Methods and importance of meta-analyses are critically discussed as well as the meaning of the term publication bias. The new documentation- and information techniques will improve some steps in the transfer process. At the end it will be crucial whether the last step, the improvement of rationality in patient care, will be successful. This evidence still has to be demonstrated.     

Die Schulter in der manuellen Medizin

The shoulder joint has a special status in many conditions, whereby the main problematic lies in the differential diagnosis of motor disturbances of the shoulder joint and shoulder pain. This article presents a review of the anatomical circumstances, the possible methods of examination and the treatment strategies.     

Die Rolle der Muskulatur in der Manuellen Medizin

Ohne Zusammenfassung     

Neues aus der Internationalen Gesellschaft für Manuelle Medizin

Ohne Zusammenfassung Auszüge aus: FIMM NEW Volume 10 Januar 2003 No.1     

Die professionalisierte Akademisierung der Physiotherapie/manuellen Therapie

Physiotherapy studies in manual medicine at the university level have been internationally implemented for many years. The academic potential is enormous with a high proportion of graduates (90%) and a high annual graduate number (n=6,000) among physiotherapists. Universities are therefore increasingly looking for ways to introduce studies in physiotherapy in Germany. The proportion of universities which offer courses in manual medicine is very low. In accordance with the key qualifications for physiotherapy the way to a self-employed medical profession can only be achieved by demonstrating competence in manual medical examination and treatment techniques and the acquisition of approval to practice medicine. Studies of complementary medicine supplemented by manual therapy would therefore offer the ideal prerequisites.